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Wilke HJ, Sciortino V. The past, present, and the future of disc nucleus replacement. A systematic review of a large diversity of ideas and experiences. Biomaterials 2025; 312:122717. [PMID: 39121730 DOI: 10.1016/j.biomaterials.2024.122717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 07/10/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024]
Abstract
Disc nucleus replacement (NR) is a challenging surgical technique used as a medical treatment for early-stage disc herniation to restore disc height and the biomechanical function of a motion segment, which may reduce low back pain. The surgical procedure involves the removal and replacement of the degenerated nucleus pulposus with a substitute by accessing the annulus fibrosos via a created hole. Over the decades, nucleus replacement has been an important issue, leading to the development of different substitute alternatives. The first ideas are dated to the 1950s and since then, more than a hundred nucleus replacement concepts can be identified. There were numerous attempts and several clinical trials; however, after more than 70 years of research, no gold standard for nucleus pulposus replacement has been identified. This review aims to collect the different nucleus replacements reported in the literature, thus understanding what failed, what could be improved and what are the opportunities for the future. A systematic review of the literature was performed using a keyword-based search on PubMed, Web of Science, and Scopus databases to detect all nucleus replacements presented in the past by clinicians and engineers. Several studies were extracted from which the main nucleus replacements over the years were investigated, including the ones that received CE mark, FDA approval, or IDE approval and, also those involved in clinical trials. A total of 116 studies were included in this review. The extracted data concern the nucleus replacements proposed over the years to create a historical background as complete as possible, including their mechanical and biomechanical characterization and the clinical trials conducted over the years. Nucleus disc arthroplasty has been explored for many years. Unfortunately, even today there is still nothing safe and definitive in this surgical practice. This review provides an overview of the nucleus replacement history. A breakthrough could be the improvements in technologies for the annulus fibrous closing or sealing and the tissue engineering and medical regenerative techniques which could certainly ensure a higher NR implantation success rate in the future of this clinical treatment. It is not yet clear what is the future of this clinical practice. Only scientific research can answer the question: is the nucleus replacement still a possible clinical solution?
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Affiliation(s)
- Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Trauma Research Centre Ulm, Ulm University, Helmholtzstrabe 14, Ulm 89081, Germany.
| | - Vincenza Sciortino
- Institute of Orthopaedic Research and Biomechanics, Trauma Research Centre Ulm, Ulm University, Helmholtzstrabe 14, Ulm 89081, Germany; University of Palermo, Department of Engineering, Viale delle Scienze, 90128 Palermo, Italy
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2
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Cheers GM, Weimer LP, Neuerburg C, Arnholdt J, Gilbert F, Thorwächter C, Holzapfel BM, Mayer-Wagner S, Laubach M. Advances in implants and bone graft types for lumbar spinal fusion surgery. Biomater Sci 2024; 12:4875-4902. [PMID: 39190323 DOI: 10.1039/d4bm00848k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
The increasing prevalence of spinal disorders worldwide necessitates advanced treatments, particularly interbody fusion for severe cases that are unresponsive to non-surgical interventions. This procedure, especially 360° lumbar interbody fusion, employs an interbody cage, pedicle screw-and-rod instrumentation, and autologous bone graft (ABG) to enhance spinal stability and promote fusion. Despite significant advancements, a persistent 10% incidence of non-union continues to result in compromised patient outcomes and escalated healthcare costs. Innovations in lumbar stabilisation seek to mimic the properties of natural bone, with evolving implant materials like titanium (Ti) and polyetheretherketone (PEEK) and their composites offering new prospects. Additionally, biomimetic cages featuring precisely engineered porosities and interconnectivity have gained traction, as they enhance osteogenic differentiation, support osteogenesis, and alleviate stress-shielding. However, the limitations of ABG, such as harvesting morbidities and limited fusion capacity, have spurred the exploration of sophisticated solutions involving advanced bone graft substitutes. Currently, demineralised bone matrix and ceramics are in clinical use, forming the basis for future investigations into novel bone graft substitutes. Bioglass, a promising newcomer, is under investigation despite its observed rapid absorption and the potential for foreign body reactions in preclinical studies. Its clinical applicability remains under scrutiny, with ongoing research addressing challenges related to burst release and appropriate dosing. Conversely, the well-documented favourable osteogenic potential of growth factors remains encouraging, with current efforts focused on modulating their release dynamics to minimise complications. In this evidence-based narrative review, we provide a comprehensive overview of the evolving landscape of non-degradable spinal implants and bone graft substitutes, emphasising their applications in lumbar spinal fusion surgery. We highlight the necessity for continued research to improve clinical outcomes and enhance patient well-being.
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Affiliation(s)
- Giles Michael Cheers
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Lucas Philipp Weimer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Carl Neuerburg
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Jörg Arnholdt
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Fabian Gilbert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Christoph Thorwächter
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Boris Michael Holzapfel
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Susanne Mayer-Wagner
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Markus Laubach
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
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Costanzo R, Ferini G, Brunasso L, Bonosi L, Porzio M, Benigno UE, Musso S, Gerardi RM, Giammalva GR, Paolini F, Palmisciano P, Umana GE, Sturiale CL, Di Bonaventura R, Iacopino DG, Maugeri R. The Role of 3D-Printed Custom-Made Vertebral Body Implants in the Treatment of Spinal Tumors: A Systematic Review. Life (Basel) 2022; 12:life12040489. [PMID: 35454979 PMCID: PMC9030237 DOI: 10.3390/life12040489] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
In spinal surgery, 3D prothesis represents a useful instrument for spinal reconstruction after the removal of spinal tumors that require an “en bloc” resection. This represents a complex and demanding procedure, aiming to restore spinal length, alignment and weight-bearing capacity and to provide immediate stability. Thus, in this systematic review the authors searched the literature to investigate and discuss the advantages and limitations of using 3D-printed custom-made vertebral bodies in the treatment of spinal tumors. A systematic literature review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, with no limits in terms of date of publication. The collected studies were exported to Mendeley. The articles were selected according to the following inclusion criteria: availability of full articles, full articles in English, studies regarding the implant of 3D custom-made prothesis after total or partial vertebral resection, studies regarding patients with a histologically confirmed diagnosis of primary spinal tumor or solitary bone metastasis; studies evaluating the implant of 3d custom-made prothesis in the cervical, thoracic, and lumbar spine. Nineteen published studies were included in this literature review, and include a total of 87 patients, 49 males (56.3%) and 38 females (43.7%). The main tumoral location and primary tumor diagnosis were evaluated. The 3D custom-made prothesis represents a feasible tool after tumor en-bloc resection in spinal reconstruction. This procedure is still evolving, and long-term follow-ups are mandatory to assess its safeness and usefulness.
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Affiliation(s)
- Roberta Costanzo
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
- Correspondence: ; Tel.: +39-0916554656
| | - Gianluca Ferini
- Department of Radiation Oncology, REM Radioterapia s.r.l., 95125 Catania, Italy;
| | - Lara Brunasso
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Lapo Bonosi
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Massimiliano Porzio
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Umberto Emanuele Benigno
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Sofia Musso
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Rosa Maria Gerardi
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Giuseppe Roberto Giammalva
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Federica Paolini
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Paolo Palmisciano
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95100 Catania, Italy; (P.P.); (G.E.U.)
| | - Giuseppe Emmanuele Umana
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95100 Catania, Italy; (P.P.); (G.E.U.)
| | - Carmelo Lucio Sturiale
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (C.L.S.); (R.D.B.)
| | - Rina Di Bonaventura
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (C.L.S.); (R.D.B.)
| | - Domenico Gerardo Iacopino
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
| | - Rosario Maugeri
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (L.B.); (L.B.); (M.P.); (U.E.B.); (S.M.); (R.M.G.); (G.R.G.); (F.P.); (D.G.I.); (R.M.)
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Zhu M, Tan J, Liu L, Tian J, Li L, Luo B, Zhou C, Lu L. Construction of biomimetic artificial intervertebral disc scaffold via 3D printing and electrospinning. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112310. [PMID: 34474861 DOI: 10.1016/j.msec.2021.112310] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/16/2022]
Abstract
Intervertebral disc (IVD) degeneration is a clinically disease that seriously endangers people's health. Tissue engineering provides a promising method to repair and regenerate the damaged IVD physiological function. Successfully tissue-engineered IVD scaffold should mimic the native IVD histological and macro structures. Here, 3D printing and electrospinning were combined to construct an artificial IVD composite scaffold. Poly lactide (PLA) was used to print the IVD frame structure, the oriented porous poly(l-lactide)/octa-armed polyhedral oligomeric silsesquioxanes (PLLA/POSS-(PLLA)8) fiber bundles simulated the annulus fibrosus (AF), and the gellan gum/poly (ethylene glycol) diacrylate (GG/PEGDA) double network hydrogel loaded with bone marrow mesenchymal stem cells (BMSCs) simulated the nucleus pulposus (NP) structure. Morphological and mechanical tests showed that the structure and mechanical properties of the IVD scaffold were similar to that of the natural IVD. The compression modulus of the scaffold is about 10 MPa, which is comparable to natural IVD and provides good mechanical support for tissue repair and regeneration. At the same time, the porosity and mechanical properties of the scaffold can be regulated through the 3D model design. In the AF structure, the fiber bundles are oriented concentrically with each subsequent layer oriented 60° to the spinal column, and can withstand the tension generated during the deformation of the NP. In the NP structure, BMSCs were evenly distributed in the hydrogel and could maintain high cell viability. Animal experiment results demonstrated that the biomimetic artificial IVD scaffold could maintain the disc space and produce the new extracellular matrix. This engineered biomimetic IVD scaffold is a promising biomaterial for individualized IVD repair and regeneration.
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Affiliation(s)
- Meiling Zhu
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Jianwang Tan
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Lu Liu
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Jinhuan Tian
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Lihua Li
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Binghong Luo
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Changren Zhou
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China
| | - Lu Lu
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China.
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5
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Vlad MD, Fernández Aguado E, Gómez González S, Ivanov IC, Şindilar EV, Poeată I, Iencean AŞ, Butnaru M, Avădănei ER, López López J. Novel titanium-apatite hybrid scaffolds with spongy bone-like micro architecture intended for spinal application: In vitro and in vivo study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110658. [PMID: 32204086 DOI: 10.1016/j.msec.2020.110658] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/05/2020] [Accepted: 01/08/2020] [Indexed: 12/20/2022]
Abstract
Titanium alloy scaffolds with novel interconnected and non-periodic porous bone-like micro architecture were 3D-printed and filled with hydroxyapatite bioactive matrix. These novel metallic-ceramic hybrid scaffolds were tested in vitro by direct-contact osteoblast cell cultures for cell adhesion, proliferation, morphology and gene expression of several key osteogenic markers. The scaffolds were also evaluated in vivo by implanting them on transverse and spinous processes of sheep's vertebras and subsequent histology study. The in vitro results showed that: (a) cell adhesion, proliferation and viability were not negatively affected with time by compositional factors (quantitative MTT-assay); (b) the osteoblastic cells were able to adhere and to attain normal morphology (fluorescence microscopy); (c) the studied samples had the ability to promote and sustain the osteogenic differentiation, matrix maturation and mineralization in vitro (real-time quantitative PCR and mineralized matrix production staining). Additionally, the in vivo results showed that the hybrid scaffolds had greater infiltration, with fully mineralized bone after 6 months, than the titanium scaffolds without bioactive matrix. In conclusion, these novel hybrid scaffolds could be an alternative to the actual spinal fusion devices, due to their proved osteogenic performance (i.e. osteoinductive and osteoconductive behaviour), if further dimensional and biomechanical optimization is performed.
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Affiliation(s)
- Maria Daniela Vlad
- Faculty of Medical Bioengineering, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Kogălniceanu 9-13, 700454 Iasi, Romania; TRANSCEND Research Centre, Regional Institute of Oncology, Str. G-ral Henri Mathias Berthelot 2-4, 700483 Iași, Romania.
| | - Enrique Fernández Aguado
- Research Group of Interacting Surfaces in Bioengineering and Materials Science (InSup), Technical University of Catalonia (UPC), Avda. Diagonal 647, 08028 Barcelona, Spain
| | - Sergio Gómez González
- Research Group of Interacting Surfaces in Bioengineering and Materials Science (InSup), Technical University of Catalonia (UPC), Avda. Diagonal 647, 08028 Barcelona, Spain
| | - Iuliu Cristian Ivanov
- TRANSCEND Research Centre, Regional Institute of Oncology, Str. G-ral Henri Mathias Berthelot 2-4, 700483 Iași, Romania
| | - Eusebiu Viorel Şindilar
- Faculty of Veterinary Medicine, University "Ion Ionescu de la Brad" of Agricultural Sciences and Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489 Iasi, Romania
| | - Ion Poeată
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Universității no. 16, 700115 Iasi, Romania
| | - Andrei Ştefan Iencean
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Universității no. 16, 700115 Iasi, Romania
| | - Maria Butnaru
- Faculty of Medical Bioengineering, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Kogălniceanu 9-13, 700454 Iasi, Romania
| | - Elena Roxana Avădănei
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy from Iasi, Str. Universității no. 16, 700115 Iasi, Romania
| | - José López López
- Research Group of Interacting Surfaces in Bioengineering and Materials Science (InSup), Technical University of Catalonia (UPC), Avda. Diagonal 647, 08028 Barcelona, Spain
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Zhang B, Skelly JD, Maalouf JR, Ayers DC, Song J. Multifunctional scaffolds for facile implantation, spontaneous fixation, and accelerated long bone regeneration in rodents. Sci Transl Med 2019; 11:11/502/eaau7411. [DOI: 10.1126/scitranslmed.aau7411] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/23/2019] [Accepted: 06/05/2019] [Indexed: 12/16/2022]
Abstract
Graft-guided regenerative repair of critical long bone defects achieving facile surgical delivery, stable graft fixation, and timely restoration of biomechanical integrity without excessive biotherapeutics remains challenging. Here, we engineered hydration-induced swelling/stiffening and thermal-responsive shape-memory properties into scalable, three-dimensional–printed amphiphilic degradable polymer-osteoconductive mineral composites as macroporous, non–load-bearing, resorbable synthetic grafts. The distinct physical properties of the grafts enabled straightforward surgical insertion into critical-size rat femoral segmental defects. Grafts rapidly recovered their precompressed shape, stiffening and swelling upon warm saline rinse to result in 100% stable graft fixation. The osteoconductive macroporous grafts guided bone formation throughout the defect as early as 4 weeks after implantation; new bone remodeling correlated with rates of scaffold composition-dependent degradation. A single dose of 400-ng recombinant human bone morphogenetic protein-2/7 heterodimer delivered via the graft accelerated bone regeneration bridging throughout the entire defect by 4 weeks after delivery. Full restoration of torsional integrity and complete scaffold resorption were achieved by 12 to 16 weeks after surgery. This biomaterial platform enables personalized bone regeneration with improved surgical handling, in vivo efficacy and safety.
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Du L, Yang Q, Zhang J, Zhu M, Ma X, Zhang Y, Wang L, Xu B. Engineering a biomimetic integrated scaffold for intervertebral disc replacement. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 96:522-529. [PMID: 30606562 DOI: 10.1016/j.msec.2018.11.087] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 10/23/2018] [Accepted: 11/30/2018] [Indexed: 12/16/2022]
Abstract
Tissue engineering technology provides a promising alternative to restore physiological functionality of damaged intervertebral disc (IVD). Advanced tissue engineering strategies for IVD have increasingly focused on engineering IVD regions combined the inner nucleus pulposus (NP) and surrounding annulus fibrosus (AF) tissue. However, simulating the cellular and matrix structures and function of the complex structure of IVD is still a critical challenge. Toward this goal, this study engineered a biomimetic AF-NP composite with circumferentially oriented poly(ε-caprolactone) microfibers seeded with AF cells, with an alginate hydrogel encapsulating NP cells as a core. Fluorescent imaging and histological analysis showed that AF cells spread along the circumferentially oriented PCL microfibers and NP cells colonized in the alginate hydrogel similar to native IVD, without obvious migration and mixing between the AF and NP region. Engineered IVD implants showed progressive tissue formation over time after subcutaneous implantation in nude mice, which were indicated by deposition and organization of extracellular matrix and enhanced mechanical properties. In terms of form and function of IVD-like tissue, our engineered biomimetic AF-NP composites have potential application for IVD replacement.
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Affiliation(s)
- Lilong Du
- Department of Minimally Invasive Spine Surgery, Tianjin Hospital, Tianjin 300211, People's Republic of China
| | - Qiang Yang
- Department of Minimally Invasive Spine Surgery, Tianjin Hospital, Tianjin 300211, People's Republic of China
| | - Jiamin Zhang
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, People's Republic of China
| | - Meifeng Zhu
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, People's Republic of China
| | - Xinlong Ma
- Department of Minimally Invasive Spine Surgery, Tianjin Hospital, Tianjin 300211, People's Republic of China
| | - Yang Zhang
- Tianjin Orthopedic Institute, Tianjin 300211, People's Republic of China
| | - Lianyong Wang
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, People's Republic of China.
| | - Baoshan Xu
- Department of Minimally Invasive Spine Surgery, Tianjin Hospital, Tianjin 300211, People's Republic of China.
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Park JY, Park SH, Kim MG, Park SH, Yoo TH, Kim MS. Biomimetic Scaffolds for Bone Tissue Engineering. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1064:109-121. [PMID: 30471029 DOI: 10.1007/978-981-13-0445-3_7] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The use of biomimetic scaffolds for bone tissue engineering has been studied for a long time. Biomimetic scaffolds can assist and accelerate bone regeneration that is similar to that of authentic tissue, which represents the environment of cells in a living organism. Currently, numerous biomaterials have been reported for use as a biomimetic scaffold. This review focuses on the design of biomimetic scaffolds, kinds of biomaterials and methods used to fabricate biomimetic scaffolds, growth factors used with biomimetic scaffold for bone regeneration, mobilization of biological agents into biomimetic scaffolds, and studies on (pre)clinical bone regeneration from biomimetic scaffolds. Then, future prospects for biomimetic scaffolds are discussed.
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Affiliation(s)
- Joon Yeong Park
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
| | - Seung Hun Park
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
| | - Mal Geum Kim
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
| | - Sang-Hyug Park
- Department of Biomedical Engineering, Pukyong National University, Busan, South Korea
| | - Tae Hyeon Yoo
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
| | - Moon Suk Kim
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea.
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